Bouncing Babies and Safe Motherhood in Sri Lanka

Reading the story today of Sri Lanka’s emergence as a success story in safer childbirth with a remarkable decline in maternal deaths, I mused about how I took for granted that childbirth would be safe when I had my children way back in the early 70’s. It was joy unlimited as I breezed through pregnancies always under the stern but very caring eye of my GP, Dr. Navaratnam. The news today that Sri Lanka should be held as an example for other South Asian countries makes me very grateful for the high quality of medical care that was available to us.

Presenting a paper at the Royal College of Obstetricians and Gynecologists, UK, South Asia Day, Dr Hemantha Senanayake, from the University of Colombo, said the “mortality ratio of Sri Lanka has declined dramatically as a direct result of the availability of midwives and trained assistance. “In 1960, the child mortality was 340 per 100,000; however, it was lowered to 43 per 100,000 live births in 2005.”

Dr. Senanayake attributed it to Government policies adopted in the past few decades and among these the decision to increase the number of midwives. The number of women in Sri Lanka having a minimum of 4 antenatal visits has reached 99 percent in Sri Lanka, said a news report on this conference on the Sri Lanka Government’s Official website.

Ensuring babies stay healthy with immunization and growth checks at the well baby clinic at Mahiyangana Base Hospital. World Bank supported Health Sector Development Project.

Photo Credit: (c) Shahidul Alam

Visiting the Mahiyangana Base Hospital supported by the World Bank assisted Health Sector Development project last year, it was a lovely sight to see young mothers with their babies in an attractively decorated waiting room. There were a fair number of twins, on a regular Friday. There were also fathers and grandmothers, aunts and uncles—holding, helping, coo-cooing and going ga-ga over their offspring. Babies usually bring out the best in families here, and this was proof indeed. But what was even more amazing was that there was not a single mother with a baby bottle. All babies were breast fed and mothers were there with their babies for regular health checks and immunizations.

Sri Lanka has encouraged breast feeding and discouraged home births (1 percent in 2006) and the availability of comprehensive emergency obstetric care is being expanded. Presently, 85 percent of births take place in facilities that have the services of a specialist obstetrician.

We also visited a smaller clinic run by a midwife in Moneragala. But she said she had only one delivery for the whole year! Most of her work is on pre-natal and post-natal care. Midwives like her are recruited from villages close to Maternal Care Centers where they are meant to serve, which ensures minimal geographic and cultural barriers to providing service we can deservedly be proud of.

Photo Credit: (c) Chulie De Silva

The midwife tends to bond easily with the mothers to be. As was the case with Dharshini Perera, a health nurse I met at an Internally Displaced People’s (IDP) camp at Nannadan in the North of Sri Lanka. Dharshini spoke fluently in Tamil, her mother’s tongue. Caring and tender, I watched her as she checked on the children and had a following like the Pied Piper in a little while. She is a fine example of the hallmark of the service — low-cost and indigenous.

Going back to the time when I was born many many moons ago, and an oft repeated story by my father springs to mind. Father to be was waiting at the railway station to meet the Midwife who was coming from Colombo for my birth. For no apparent reason on that New Year’s Day, the train whizzed past the Hikkaduwa station to Galle, leaving my father gaping in disbelief. My father’s Colonial relic “clerk” came to the rescue of his panic stricken boss and a local midwife found. The rest as they say is history. But the fact is that even way back then it was a hallmark of a good service.

Thanks for the great entry Chulie. I was wondering, is there a specialized training programs for midwives organized by the government or private organizations or is it something that's passed down from one generation to the next? Thanks!

My son is almost 9 months old and I feel like I haven't gotten to watch him grow up. I had him and went back to work after four weeks and he has been with a nanny ever since. I work 6 days a week and my husband does as well. We work at Narconon drug rehab and with the problem int he US today, we can't afford to take off any. How can I manage my time more so that I don't feel like I am missing out on my sons childhood?